Geriatric patients with hip fractures often experience overlap in problems related to nutrition, including undernutrition, sarcopenia, and frailty. Such problems are powerful predictors of adverse responses, although few healthcare professionals are aware of them and therefore do not implement effective interventions. This review aimed to summarize the impact of undernutrition, sarcopenia, and frailty on clinical outcomes in elderly individuals with hip fractures and identify successful strategies that integrate nutrition and rehabilitation. We searched PubMed (MEDLINE) and Cochrane Central Register of Controlled Trials (CENTRAL) for relevant literature published over the last 10 years and found that advanced interventions targeting the aforementioned conditions helped to significantly improve postoperative outcomes among these patients. Going forward, protocols from advanced interventions for detecting, diagnosing, and treating nutrition problems in geriatric patients with hip fractures should become standard practice in healthcare settings.
Osteopenia/osteoporosis and sarcopenia are common geriatric diseases among older adults and harm activities of daily living (ADL) and quality of life (QOL). Osteosarcopenia is a unique syndrome that is a concomitant of both osteopenia/osteoporosis and sarcopenia. This review aimed to summarize the related factors and clinical outcomes of osteosarcopenia to facilitate understanding, evaluation, prevention, treatment, and further research on osteosarcopenia. We searched the literature to include meta-analyses, reviews, and clinical trials. The prevalence of osteosarcopenia among community-dwelling older adults is significantly higher in female (up to 64.3%) compared to male (8–11%). Osteosarcopenia is a risk factor for death, fractures, and falls based on longitudinal studies. However, the associations between osteosarcopenia and many other factors have been derived based on cross-sectional studies, so the causal relationship is not clear. Few studies of osteosarcopenia in hospitals have been conducted. Osteosarcopenia is a new concept and has not yet been fully researched its relationship to clinical outcomes. Longitudinal studies and high-quality interventional studies are warranted in the future.
Interventions for stroke-related sarcopenia in patients with stroke are needed, but the details of the target population are unclear. This systematic review aimed to identify trajectories of the prevalence of sarcopenia in the pre- and post-stroke periods and to determine the diagnostic criteria used in patients with stroke. We searched for literature in six databases: MEDLINE, EMBASE, Web of Science, Cochrane Central Register of Controlled Trials, CINAHL, and Ichushi-web (in Japanese). We included 1627 studies in the primary screening, and 35 studies were finally included. Of the 35 studies, 32 (91.4%) included Asian patients, and the criteria of the Asian Working Group for Sarcopenia was mainly used as the diagnostic criteria. Nineteen studies used muscle strength and muscle mass to diagnose sarcopenia, whereas a full assessment, including physical performance, was performed in five studies. The estimated prevalences of sarcopenia in pre-stroke, within 10 days of stroke, and from 10 days to 1 month after stroke were 15.8%, 29.5%, and 51.6%, respectively. Sarcopenia increased by approximately 15% from pre-stroke to 10 days, and increased by approximately 20% from 10 days to 1 month. Healthcare providers should note that the prevalence of sarcopenia increases during the acute phase in patients with stroke.
1 March 2021 in Archives of Gerontology and Geriatrics